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At a budget hearing on Tuesday, the Alabama Department of Public Health presented its preliminary requests from the state funds for the 2026 fiscal year.
Although the ADPH is predominantly federally funded, around 7 percent of the department’s budget comes from the General Fund, with additional allocations from the Education Fund and other miscellaneous state funds.
The 2026 fiscal year is projected to require an additional $42 million from the General Fund and $319,000 from the Education Fund. Some of these funds are continuation costs to provide merit raises and insurance for department employees. There is an estimated $6 million for initiatives to provide clinical and physical services to the state.
Though the exact initiatives are not set in stone, the funds are expected to be put towards areas that urgently need improvement like maternity deserts in the Black Belt and the opioid crisis. Another area of need that was identified in the meeting to receive initiative funds was the Lowndes County wastewater crisis.
The majority of funds, around $34 million, would go toward the Children’s Health Insurance Program, bringing the total funds for the program up to $91 million in 2026. This represents a 61 percent increase in the program funding as compared to the $56 million budgeted in the 2025 fiscal year.
What makes the 2026 fiscal year different from the years previous is the amount of rollover funds going toward the program. Between 2020-2022 more children were enrolled in Medicaid than in CHIP. Once children were enrolled in Medicaid during those years, they could not return to the CHIP program.
In 2023, Alabama began unenrolling residents from Medicaid after the expiration of COVID-related federal protections and since then nearly 200,000 Alabamians are left without coverage. As a result, the number of children enrolled in CHIP and Medicaid began to even out with each other quicker than expected.
Appropriations are normally higher than the actual expenses, but the rollover funds are decreasing. ADPH is predicting a negative end balance of $10 million when the 2025 fiscal year ends. The dramatic increase in requested funds for 2026 aims to compensate for the deficit.
